Individual
PAUL I AVIDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1050 SE MONTEREY RD STE 400, STUART, FL 34994-4512
(772) 288-2400
Mailing address
1050 SE MONTEREY RD, SUITE 400, STUART, FL 34994-4512
(772) 288-2400
(772) 419-0143
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0001609
FL
363AS0400X
Surgical Physician Assistant
Primary
PA0001609
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4181
MEDICARE SPECIFIED
—
Enumeration date
12/07/2005
Last updated
10/26/2020
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